Nosocomial outbreak of vancomycin-resistant Enterococcus faecium at a German University Pediatric Hospital

Elsner, Holger-Andreas; Sobottka, Ingo; Feucht, Heinz‐Hubert; Harps, E.; Haun, Christoph; Mack, Dietrich; Ganschow, Rainer; Laufs, Rainer; Kaulfers, Paul-Michael

doi:10.1078/s1438-4639(04)70020-6

Cited by 20 publications

(6 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Of the 12 studies conducted in the Netherlands, eight were outbreak reports (Table 1 ) [ 34 – 41 ]. Of the 32 German publications, six were outbreak reports (Table 2 ) [ 42 – 47 ]. All outbreaks in both countries were caused by VREfm.…”

Section: Resultsmentioning

confidence: 99%

“…All outbreaks in both countries were caused by VREfm. In three of eight outbreaks observed in Dutch hospitals and in four of six outbreaks observed in German hospitals, VREfm infections were reported alongside patients colonized with VREfm [ 34 , 37 , 40 , 42 , 45 – 47 ]. One common factor observed in these reports was that colonization played a pivotal role in the occurrence of outbreaks in both countries.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Vancomycin-resistant enterococci (VRE) in hospital settings across European borders: a scoping review comparing the epidemiology in the Netherlands and Germany

Cimen

Berends

Bathoorn

et al. 2023

Antimicrob Resist Infect Control

View full text Add to dashboard Cite

The rising prevalence of vancomycin-resistant enterococci (VRE) is a matter of concern in hospital settings across Europe without a distinct geographical pattern. In this scoping review, we compared the epidemiology of vancomycin-resistant Enterococcus spp. in hospitals in the Netherlands and Germany, between 1991 and 2022. We searched PubMed and summarized the national antibiotic resistance surveillance data of the two countries. We included 46 studies and summarized national surveillance data from the NethMap in the Netherlands, the National Antimicrobial Resistance Surveillance database in Germany, and the EARS-Net data. In total, 12 studies were conducted in hospitals in the Netherlands, 32 were conducted in German hospitals, and an additional two studies were conducted in a cross-border setting. The most significant difference between the two countries was that studies in Germany showed an increasing trend in the prevalence of VRE in hospitals, and no such trend was observed in studies in the Netherlands. Furthermore, in both Dutch and German hospitals, it has been revealed that the molecular epidemiology of VREfm has shifted from a predominance of vanA towards vanB over the years. According to national surveillance reports, vancomycin resistance in Enterococcus faecium clinical isolates fluctuates below 1% in Dutch hospitals, whereas it follows an increasing trend in German hospitals (above 20%), as supported by individual studies. This review demonstrates that VRE is more frequently encountered in German than in Dutch hospitals and discusses the underlying factors for the difference in VRE occurrence in these two neighboring countries by comparing differences in healthcare systems, infection prevention control (IPC) guidelines, and antibiotic use in the Netherlands and Germany.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Vancomycin-resistant enterococci (VRE) in hospital settings across European borders: a scoping review comparing the epidemiology in the Netherlands and Germany

Cimen

Berends

Bathoorn

et al. 2023

Antimicrob Resist Infect Control

View full text Add to dashboard Cite

show abstract

“…Their VanA phenotype was genotypically confirmed by colony hybridization and PCR in a previous study about a nosocomial outbreak of vancomycin-resistant enterococci (VRE) at University Hospital Eppendorf. Those 2 isolates were found to be of different genotypes, as determined by pulsed-field gel electrophoresis [14].…”

Section: Discussionmentioning

confidence: 99%

In vitro Susceptibilities of Enterococcal Blood Culture Isolates from the Hamburg Area to Ten Antibiotics

Elsner

Sobottka²,

Claußen³

et al. 2000

Chemotherapy

Self Cite

View full text Add to dashboard Cite

Treatment of enterococcal infections is often difficult because of intrinsic and acquired resistance to a variety of antimicrobial agents. Between January 1993 and May 1997, enterococci were isolated from blood cultures of 117 patients at the Institute of Medical Microbiology and Immunology, University Hospital Eppendorf, Hamburg, Germany. Eightynine (76%) isolates were phenotypically identified as Enterococcus faecalis, and 24 (21%) as Enterococcus faecium. All E. faecalis isolates, but only 17% of the E. faecium isolates were susceptible to ampicillin. Two E. faecium isolates (8%) but no E. faecalis were vancomycin resistant (vanA genotype). Quinupristin/dalfopristin shows a high degree of susceptiblity of E. faecium (79%) and may be suitable for the therapy of infections caused by glycopeptide-resistant E. faecium strains.

show abstract

“…[49] It was streptogramin class, also inhibits bacterial protein synthesis. [61] determined that 47% of these children had community-acquired This agent has also shown good results with resistant Gram-MRSA without known risk factors, and soft tissue infections were positive organisms [61,64] but studies in children are lacking. In one seen in 91% of these patients.…”

Section: Pyomyositismentioning

confidence: 99%

Children Hospitalized with Skin and Soft Tissue Infections

Vayalumkal

Jadavji

2006

Pediatric Drugs

View full text Add to dashboard Cite

Skin and soft tissue infections in children are an important cause for hospitalization. A thorough history and physical examination can provide clues to the pathogens involved. Collection of purulent discharge from lesions should be completed prior to initiating antimicrobial therapy, and results of bacteriologic studies (Gram stain and culture) should guide therapeutic decisions. The main pathogens involved in these infections are Staphylococcus aureus and group A beta-hemolytic streptococci, but enteric organisms also play a role especially in nosocomial infections. Increasing antibacterial resistance is becoming a major problem in the treatment of these infections worldwide. Specifically, the rise of methicillin-resistant S. aureus and glycopeptide-resistant S. aureus pose challenges for the future. Infections of the skin and soft tissues can be broadly classified based on the extent of tissue involvement. Superficial infections such as erysipelas, cellulitis, bullous impetigo, bite infections, and periorbital cellulitis may require hospitalization and parenteral antibacterials. Deeper infections such as orbital cellulitis, necrotizing fasciitis, and pyomyositis require surgical intervention as well as parenteral antibacterial therapy. Surgery plays a key role in the treatment of abscesses and for the debridement of necrotic tissue in deep infections. Intravenous immunoglobulin, as an adjunctive therapy, can be helpful in treating necrotizing fasciitis. For most infections an antistaphylococcal beta-lactam antibacterial is first-line therapy. Third-generation cephalosporins and beta-lactam/beta-lactamase inhibitor antibacterials as well as clindamycin or metronidazole are often required to provide broad-spectrum coverage for polymicrobial infections.Special populations, such as immunocompromised children, those with an allergy to penicillins, and those that acquire infections in hospitals, require specific antibacterial strategies. These usually involve broader antimicrobial coverage with increased Gram-negative (including antipseudomonal) and anerobic coverage. In patients with a true allergy to penicillins, clindamycin and vancomycin play an important role in treating Gram-positive infections. Newer antibacterial agents, such as linezolid and quinupristin/dalfopristin, are increasingly being studied in children for the treatment of skin and soft tissue infections. These agents hold promise for the future especially in the treatment of highly resistant, Gram-positive organisms such as methicillin-resistant S. aureus, vancomycin-resistant S. aureus, and vancomycin-resistant enterococci.

show abstract

Nosocomial outbreak of vancomycin-resistant Enterococcus faecium at a German University Pediatric Hospital

Cited by 20 publications

References 22 publications

Vancomycin-resistant enterococci (VRE) in hospital settings across European borders: a scoping review comparing the epidemiology in the Netherlands and Germany

Vancomycin-resistant enterococci (VRE) in hospital settings across European borders: a scoping review comparing the epidemiology in the Netherlands and Germany

In vitro Susceptibilities of Enterococcal Blood Culture Isolates from the Hamburg Area to Ten Antibiotics

Children Hospitalized with Skin and Soft Tissue Infections

Contact Info

Product

Resources

About